| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STRATEGIC BUSINESS SERVICES3 Filed as: STRATEGIC BUSINESS SERVICE AGENCY | 110 EAST WILSON BRIDGE ROAD SUITE 260 WORTHINGTON, OH 43085 | MEDICAL MUTUAL | $6K | — | $6K | 2.41% |
| STRATEGIC BUSINESS SERVICES3 | 110 E WILSON BRIDGE RD SUITE 260 WORTHINGTON, OH 43085 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.45% |
| STRATEGIC BUSINESS SERVICES3 | 110 E WILSON RD SUITE 260 WORTHINGTON, OH 43085 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $638 | — | $638 | 19.99% |
| STRATEGIC BUSINESS SERVICES3 | 110 E WILSON BRIDGE RD SUITE 260 WORTHINGTON, OH 43085 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $299 | — | $299 | 9.99% |
| STRATEGIC BUSINESS SERVICES3 | 110 E WILSON BRIDGE RD SUITE 260 WORTHINGTON, OH 43085 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $325 | — | $325 | 12.14% |
| STRATEGIC BUSINESS SERVICES3 | 110 E WILSON BRIDGE RD SUITE 260 WORTHINGTON, OH 43085 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $223 | — | $223 | 10.01% |
| STRATEGIC BUSINESS SERVICES3 | 425 METRO PACE NORTH SUITE 140 DUBLIN, OH 43017 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $123 | — | $123 | 8.96% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 158 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 143 | $235K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $15K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 221 | $1K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $6K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $2K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $3K |
| Prescription drug | MEDICAL MUTUAL | 143 | $235K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.